Immunization gaps and measles outbreaks in ASEAN (2015-2025): A systematic review and meta-analysis.

The varicella-zoster virus (VZV) vaccine strain may reactivate to cause herpes zoster. Limited data suggest that the risk of herpes zoster in vaccinated children could be lower than in children with naturally acquired varicella. We examine incidence trends, risk and epidemiologic and clinical features of herpes zoster disease among children and adolescents by vaccination status. Population-based active surveillance was conducted among <20 years old residents in Antelope Valley, California, from 2000 through 2006. Structured telephone interviews collected demographic, varicella vaccination and disease histories, and clinical information. From 2000 to 2006, the incidence of herpes zoster among children<10 years of age declined by 55%, from 42 cases reported in 2000 (74.8/100,000 persons; 95% confidence interval [95% CI]: 55.3-101.2) to 18 reported in 2006 (33.3/100,000; 95% CI: 20.9-52.8; P<0.001). During the same period, the incidence of herpes zoster among 10- to 19-year-olds increased by 63%, from 35 cases reported in 2000 (59.5/100,000 persons; 95% CI: 42.7-82.9) to 64 reported in 2006 (96.7/100,000; 95% CI: 75.7-123.6; P<0.02). Among children aged<10 years, those with a history of varicella vaccination had a 4 to 12 times lower risk for developing herpes zoster compared with children with history of varicella disease. Varicella vaccine substantially decreases the risk of herpes zoster among vaccinated children and its widespread use will likely reduce overall herpes zoster burden in the United States. The increase in herpes zoster incidence among 10- to 19-year-olds could not be confidently explained and needs to be confirmed from other data sources.

This study aims to assess the prevalence of neuropathic pain in the Moroccan population through a systematic review and meta-analysis using a generalized linear mixed model (GLMM). The PRISMA guidelines for systematic reviews and meta-analysis were followed. All observational prevalence studies, conducted in both the general population and hospital settings in Morocco, published before 1 December 2023, were included, provided that neuropathic pain was identified based on consensus criteria. The databases searched included PubMed, Scopus, Web of Science, and the gray literature (Google Scholar). Data on the sample size, subgroups, sociodemographic and clinical characteristics of participants, as well as the methodology of each study, were extracted. The Joanna Briggs Institute tool for prevalence studies was used to assess the risk of bias. A random-effects generalized linear mixed model was applied for direct data adjustment, using Knapp-Hartung standard error correction. Heterogeneity was explored using Cochran's Q test, Higgins' I2 statistic, and prediction intervals. Subgroup analysis was performed based on underlying pathology, while meta-regression was conducted according to age and sex ratio. Publication bias was assessed using the Doi plot and LFK test. Sensitivity analysis was performed by stratifying studies based on their risk of bias. The statistical analysis was conducted using R software version 4.3.1 with the meta, metafor, metasens, and robvis packages. A total of 33 publications were identified, of which 17 studies were retained after removing duplicates and applying the eligibility criteria. These studies were published between 2013 and 2023 and included either the general population (one study) or patients with diabetes (seven), obesity (one), rheumatologic conditions (six), Parkinson's disease (one), or cancer (one). The DN4 score was the most commonly used tool to diagnose neuropathic pain. The risk of bias was rated as low in two studies, moderate in eight, and high in seven. The pooled overall prevalence was 22% (95% CI [14.8; 31.5]) with an I2 of 98% (p < 0.01). In subgroup analyses, the prevalence was 19.9% among rheumatology patients, 10.2% in oncology patients, 9.4% in Parkinson's patients, 26.6% in diabetics, 58.6% in obese individuals, and 10.6% in the general population. Meta-regression by sex indicated significantly lower prevalence in men, and prevalence increased with age but did not reach statistical significance. After stratification based on the risk of bias, the pooled prevalence was 15.4% for the two studies with a low risk of bias. The overall prevalence of neuropathic pain in Morocco is relatively high at 22%, with significant variability across medical specialties. However, this prevalence is likely overestimated. Stronger and higher-quality studies are needed to obtain more accurate estimates.

Pharmaceutical waste management legislations: Where do ASEAN countries stand in harmonization? A review of regulatory documents.

Performing and evaluating meta-analyses

Publication bias: Graphical and statistical methods

Epidemiologic Changes Caused by the Preventive Measures for the Coronavirus Disease 2019 Pandemic: An Additional Challenge for Pediatricians

Network meta-analysis of antidepressants

Protocol Standardization of Microbiome Studies—Daunting but Necessary

Shift work is commonly increasing, and some physiological changes occur as workers sleep less and their circadian rhythms are disrupted. This umbrella review not only summarizes the evidence but also evaluates the validity of the associations of shift work with different health outcomes. We searched the MEDLINE, Web of Science, and Embase databases from their inception to April 25, 2020. For each systematic review and/or meta-analysis, we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. Eight eligible systematic reviews and meta-analyses were identified, providing data on 16 associations. We observed highly suggestive evidence for associations between shift work and myocardial infarction (having ever vs having never done shift work) and diabetes mellitus incidence (per 5-year increment in shift work). Furthermore, we observed suggestive evidence for an association between shift work and diabetes mellitus incidence (having ever vs having never done shift work). Two health outcomes, including prostate cancer incidence (having ever vs having never done shift work and rotating night shift work vs daytime work) and colorectal cancer incidence (longest vs shortest shift work time), were only supported by weak evidence. This umbrella review found that shift work was associated with several health outcomes with different levels of evidence. Associations for myocardial infarction and diabetes mellitus incidence were supported by highly suggestive evidence. Registry: PROSPERO; Identifier: CRD42020188537. Wu Q-J, Sun H, Wen Z-Y, etal. Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies. J Clin Sleep Med. 2022;18(2):653-662.

SummaryBackgroundTobacco smoking has long been a regional health priority for the Association of Southeast Asian Nations (ASEAN). Despite decades of commitment to implementing tobacco control measures, the ASEAN region continues to face substantial challenges in reversing the epidemic. We aimed to analyse longitudinal data on smoking prevalence and attributable disease burden to understand the trajectory of the smoking epidemic, inform priority setting, and enable effective policy planning.MethodsWe used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to evaluate the prevalence of tobacco smoking and its attributable disease burden in the ten ASEAN member states by age and sex, from 1990 to 2021. Current smoking prevalence was estimated using spatiotemporal Gaussian process regression models, which synthesised data from 159 distinctive data sources specific to the ASEAN region in addition to 2646 data sources from other GBD countries. Dose–response risks for 36 health outcomes were derived using the latest burden of proof approach. Population attributable fractions were subsequently calculated and applied to determine the burden in terms of mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) attributable to tobacco smoking in these countries.FindingsIn 2021, there were approximately 137 million (95% uncertainty interval 134–139) current smokers aged 15 years and older in the ASEAN region, with an estimated age-standardised prevalence of 48·4% (47·5–49·2) among males and 4·47% (4·09–4·92) among females. Tobacco smoking accounted for 10·8% (8·86–12·9) of all-cause mortality across the region. The total number of deaths and DALYs attributed to smoking were 526 000 deaths (433 000–622 000) and 15·7 million (12·9–18·5) DALYs. Death rates varied considerably across the region, especially among males, ranging from 68·9 (55·8–84·2) per 100 000 males in Singapore to 364 (279–463) per 100 000 males in Cambodia. Although smoking prevalence declined substantially in most ASEAN countries between 1990 and 2021, the absolute number of smokers increased by 63·3% (59·0–67·8), and the number of smokers aged 10 years and older increased by 53·0 million (50·2–56·2).InterpretationTobacco smoking remains a persistent public health threat in the ASEAN region. Considerable disparities exist across the region: while some countries have made remarkable progress in tobacco control, others lag behind. As a modifiable risk factor heavily influenced by commercial determinants, smoking can be controlled through effective policy changes. As a geopolitical and economic collaboration network, ASEAN countries must work together to overcome barriers hindering anti-tobacco efforts and collectively devise strategies to strengthen tobacco control across the region.FundingBloomberg Philanthropies and the Bill & Melinda Gates Foundation.

Lack of significant association between dyslipidemia and COVID-19 mortality

Regarding L-Carnitine and Cardiovascular Disease

Autism Spectrum Disorder (ASD) represents a critical public health challenge globally, yet research within the Association of Southeast Asian Nations (ASEAN) region, particularly Malaysia, remains limited and fragmented. Understanding the current landscape of ASD research from a public health perspective is essential to inform evidence-based policy development and improve service delivery for affected individuals and families. This scoping review aimed to systematically map existing research on autism spectrum disorder in ASEAN countries and Malaysia, examining key domains—epidemiology, screening and diagnosis, intervention approaches, and family experiences—through a public health lens. A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, for publications between 2000 and 2024. Studies were included if they addressed ASD from a public health perspective within the ASEAN region. Data extraction captured study characteristics, methodologies, key findings, and public health implications, with thematic synthesis employed to categorize results. This scoping review uncovered several pertinent publications, including a significant portion that specifically addresses Malaysia. Four key research areas were identified: studies on disease prevalence, practices related to screening and diagnosis, various intervention strategies, and the experiences of families. The reported prevalence rates of a particular developmental disorder among children were notably lower than global averages, suggesting considerable underdetection. Delays in obtaining diagnoses ranged widely, exceeding the recommended timeframes. Ongoing challenges included ineffective surveillance systems, insufficient training for healthcare professionals, limited access to proven interventions, cultural stigma, and financial constraints faced by families. Substantial gaps persist in ASD research, policy, and practice within ASEAN and Malaysia. Urgent priorities include establishing robust surveillance systems, implementing universal screening programs, expanding diagnostic and intervention services, developing culturally appropriate support models, and prioritizing autism as a public health imperative requiring comprehensive, coordinated responses across healthcare, education, and social welfare sectors. BJMS, Vol. 25 No. 01 January’26 Page : 28-37

Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement

Alcohol consumption among university students poses significant public health challenges, especially in the Association of Southeast Asian Nations (ASEAN) region, where limited research exists. This review aims to synthesize evidence on sociodemographic factors associated with alcohol consumption among university students in ASEAN countries, assess the study quality and identify research gaps. A systematic search across nine databases was conducted in May 2024, using Population, Intervention, Comparator, Outcome, Study Design and Timeframe to define the inclusion criteria. Studies were assessed for quality and risk of bias using the AXIS tool. Data on sociodemographic factors were extracted, and random-effects meta-analyses were performed for frequently reported factors. Heterogeneity was measured using Cochran's Q-test and I-squared statistic, and small-study bias was tested using funnel plots and Egger's test. Fifteen cross-sectional studies involving 35,527 participants met the inclusion criteria. Gender, age and parental alcohol consumption were the most commonly studied factors. Male students had three times the odds of consuming alcohol compared to female students, a result robust to sensitivity analysis. Parental alcohol use and older age were also significantly and positively associated with alcohol consumption, with minimal heterogeneity. Most studies were of high quality, although variability in study design and geographic representation limited the generalizability of the findings. Sociodemographic factors such as gender, age and parental alcohol consumption influence alcohol use among ASEAN college students. However, cross-sectional design and limited country representation highlight the need for further robust research to inform policy and interventions.